International Journal Of Fertility and Sterility
Volume:10 Issue: 3, Oct-Dec 2016

Male fertility significantly decreased in the last 50 years, as showed in several studies reporting a reduction of sperm counts per ml in the seminal fluid. Several “acute” pharmacological treatments, as antibiotics, could cause subclinical and temporary reduction of male fertility; conversely, long-term medical treatment may severely affect male fertility, although this effect could be considered transient in most of the cases. Thus, nowadays, several long-term pharmacological treatments may represent a clinical challenge. The association between several kind of antihypertensive drugs and reduction of male fertility has been showed in the mouse model, although the modification(s) which may alter this fine-regulated machinery are still far to be elucidated. Furthermore, well-designed observational studies and randomized controlled trials are needed to accurately define this association in human model, meaning a narrative overview synthesizing the findings of literature retrieved from searches of computerized databases. We strongly solicit future human studies (both observational and randomized clinical trials) on large cohorts with adequate statistical power which may clarify this possible association and the effects (reversible or permanent) of each drug. Furthermore, we suggest a close collaboration between general practitioners, cardiologists, and andrologists in order to choose the most appropriate antihypertensive therapy considering also patient’s reproductive desire and possible risk for his fertility.

Orally active aromatase inhibitors (AIs) have gained attention for treatment of infertile women with endometriosis in whom aromatase p450 is aberrantly expressed. This review aimed to critically appraise and summarize the available evidence concerning the use of AIs for management of endometriosis-associated infertility. PubMed was searched to May 2015 with the following key words: endometriosis, infertility and aromatase. Priority was given for randomized controlled trials (RCTs) followed by other study designs. Main outcome measures were as follows: rates of clinical pregnancy, miscarriage and live birth as well as endocrine outcomes. Eighty-two abstracts were screened and six original articles were included. A RCT demonstrated that post-operative letrozole treatment did not improve spontaneous pregnancy rate. Another RCT reported no superiority of letrozole superovulation over clomiphene citrate (each combined with intrauterine insemination) in minimalmild endometriosis and previous laparoscopic treatment. Anastrozole significantly inhibited the growth of endometriotic cells and their estrogen production in culture. In assisted reproductive technology (ART) cycles, dual suppression (Agonist/anastrozole) was tested in a pilot study with a pregnancy rate of 45% however, high pregnancy loss (30%) occurred. A retrospective study showed that letrozole may improve endometrial receptivity in endometriotic patients undergoing in vitro fertilization (IVF). An opposite view from an in vitro study showed lower estradiol production and aromatase expression in cultured granulosa cells from endometriotic women undergoing IVF and marked reduction under letrozole. In conclusion, current evidence is limited. More trials are warranted to enhance our knowledge and provide a clear and unequivocal evidence to guide our clinical management of infertile women with endometriosis using AIs.

Few studies have been conducted on the infertility problems in Iran. This study aimed to investigate the prevalence of infertility problems and related factors in Iranian infertile patients.
In this cross sectional study, 405 infertile patients referred to Royan Institute, Tehran, Iran, between 2014 and 2015, were selected by simple random sampling. Participants completed the Fertility Problem Inventory (FPI) including 46 questions in five domains (social concern, sexual concern, relationship concern, rejection of parenthood, and need for parenthood). Mean difference between male and female was verified using independent-samples Student’s t test. A generalized linear model (GLM) was also used for testing the effect of variables on the fertility problems. Data was analyzed using Stata software version 13.
The mean age (SD) of participants was 31.28 (5.42). Our results showed that 160 infertile men (95.23%) were classified as very high prevalence of infertility problems. Among infertile women, 83 patients (35.02%) were as very high prevalence of infertility problems, and 154 patients (64.98%) were as high prevalence. Age (P Bases on the results of current study, an younger male with lower education level, history of abortion and history of previous treatments failure experienced more infertility problems.

Due to the worldwide increase in infertility, it is both necessary and important to have assisted reproductive technology (ART) registries. In Iran, donation and surrogacy programs are approved by decrees from religious scholars. ART has been used since 1984 in Iran and the first Iranian infant conceived by gamete intra-fallopian transfer (GIFT) was born in 1989. This report, however, is the first national report on Iranian ART centers.
This cross-sectional study, conducted under the supervision of the Iranian Ministry of Health, presented a summary of the numbers and percentages of centers that provided infertility services in Iran, as well as the status of ART in Iran during 2011.
A total of 52 centers reported treatment cycles and performed approximately 29000 intrauterine insemination (IUI), in addition to 35000 in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) cycles.
Iran has considerable potential to provide IVF services for both Iranians as well as other nationalities throughout the region. This proves the need for a national center that will implement a registry system.

Fertility plays an important role in sexual and psychological function in families. Infertility can result in major emotional, social, and mental disorders, including a reduction in satisfaction with marital life and quality of life. The present study aimed to compare the quality of life and marital satisfaction and sexual satisfaction between fertile and infertile couples.
This analytical cross-sectional study was conducted on 250 couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects were randomly selected from the patients referred to this center using a table of random numbers. They were then allocated into two groups of infertile group (n=125) and fertile group (n=125). The study participants completed World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale, and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied to compare the data between the groups.
The results revealed no significant difference between the two groups regarding demographic and general health variables. The mean scores of sexual satisfaction were 63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03 in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile couples obtained significantly higher mean scores of quality of life as well as lower mean scores of sexual satisfaction and marital satisfaction as compared to the infertile ones (P According to the results, the fertile couples obtained significantly higher quality of life and lower sexual satisfaction and marital satisfaction as compared to the infertile ones. Therefore, holding consultation programs and conducting more studies are necessary for improving the quality of life and promoting sexual and marital satisfaction in infertile couples.

To verify the hypothesis that the incidence of chromosomal abnormalities increases in babies conceived by different assisted reproduction procedures. The availability of the umbilical cord blood encouraged us to study this hypothesis via this method.
This is a descriptive study, umbilical cord blood samples of assisted reproductive technology (ART) children were analyzed with standard cytogenetic techniques (G banding). Karyotyping was possible in 109 cases.
The number of abnormal cases was four (3.7%), among which, three cases (2.8%) were inherited and only 1 case (0.9%) was a de novo translocation. In total, the incidence of de novo chromosomal abnormalities was in the range observed in all live births in the general population (0.7-1%).
No significant difference in the incidence of chromosomal abnormality was found between ART and naturally conceived babies. To date, several studies have examined the medical and developmental outcome of ART children and still have not reached a definite conclusion. Genetic counseling is recommended as an integral part of planning of treatment strategies for couples wishing to undergo ART.

Several recent studies have shown that mitochondrial DNA mutations lead to major disabilities and premature death in carriers. More than 150 mutations in human mitochondrial DNA (mtDNA) genes have been associated with a wide spectrum of disorders. Varicocele, one of the causes of infertility in men wherein abnormal inflexion and distension of veins of the pampiniform plexus is observed within spermatic cord, can increase reactive oxygen species (ROS) production in semen and cause oxidative stress and sperm dysfunction in patients. Given that mitochondria are the source of ROS production in cells, the aim of this study was to scan nine mitochondrial genes (MT-COX2, MT-tRNALys , MT-ATP8, MT-ATP6, MT-COX3, MT-tRNAGly , MT-ND3, MT-tRNAArg and MT-ND4L) for mutations in infertile patients with varicocele.
In this cross-sectional study, polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and DNA sequencing were used to detect and identify point mutations respectively in 9 mitochondrial genes in 72 infertile men with varicocele and 159 fertile men. In brief, the samples showing altered electrophoretic patterns of DNA in the SSCP gel were sent for DNA sequencing to identify the exact nucleotide variation.
Ten type nucleotide variants were detected exclusively in mitochondrial DNA of infertile men. These include six novel nucleotide changes and four variants previously reported for other disorders.
Mutations in mitochondrial genes may affect respiratory complexes in combination with environmental risk factors. Therefore these nucleotide variants probably lead to impaired ATP synthesis and mitochondrial function ultimately interfering with sperm motility and infertility.

Little is understood about the regulation of gene expression during early goat embryo development. This study investigated the expression profile of 19 genes, known to be critical for early embryo development in mouse and human, at five different stages of goat in vitro embryo development (oocyte, 8-16 cell, morula, day-7 blastocyst, and day 14 blastocyst).
In this experimental study, stage-specific profiling using real time-quantitative polymerase chain reaction (RT-qPCR) revealed robust and dynamic patterns of stage-specific gene activity that fall into four major clusters depending on their respective mRNA profiles.
The gradual pattern of reduction in the maternally stored transcripts without renewal thereafter (cluster-1: Lifr1, Bmpr1, Alk4, Id3, Ctnnb, Akt, Oct4, Rex1, Erk1, Smad1 and 5) implies that their protein products are essential during early cleavages when the goat embryo is silent and reliant to the maternal legacy of mRNA. The potential importance of transcription augment at day-3 (cluster-2: Fzd, c-Myc, Cdc25a, Sox2) or day- 14 (cluster-3: Fgfr4, Nanog) suggests that they are nascent embryonic mRNAs which intimately involved in the overriding of MET or regulation of blastocyst formation, respectively. The observation of two expression peaks at both day-3 and day-14 (cluster-4: Gata4, Cdx2) would imply their potential importance during these two critical stages of preand periimplantation development.
Evolutionary comparison revealed that the selected subset of genes has been rewired in goat and human/goat similarity is greater than the mouse/goat or bovine/goat similarities. The developed profiles provide a resource for comprehensive understanding of goat preimplantation development and pluripotent stem cell engineering as well.